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Minerva Chirurgica 2011 February;66(1):21-40

Copyright © 2011 EDIZIONI MINERVA MEDICA

language: Italian

Inguinal hernia repair: an experimental study on mesh migration with the tension-free suturless technique. 10 year follow-up

Carrozza V. 1, Ivaldi L. 1, Ferro A. 1, Gennaro M. 1, Bronzino P. 1, Gambino E. 1, Guffanti P. 2, Aimo I. 1, Morino M. 2, Revetria P. 1

1 Asl CN1, Ospedale Poveri Infermi di Ceva, Ceva, Cuneo, Italia; 2 I Clinica Chirurgica, Università degli Studi di Torino, Torino, Italia


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AIM: Can the tension-free suturless technique, used in the surgical treatment of inguinal hernia, to be the gold standard for treatment of inguinal hernia?
METHODS: The tension-free suturless technique is often criticized as a fundamental principle: do not have suture. The criticism stems from concern that the mesh can migrate and cause damage to important anatomical structures. We conducted a study on the mobility of prosthesis on 33 patients, by using titanium clips that we have fixed on the meshes corner, X-rays over time, done at last, a follow-up of ten years.
RESULTS: The study shows that the prosthesis moves together with the anatomical space in which there is the forces present in the inguinal canal: gravity, intra-abdominal pressure, reactive force ascending gait. Across thirty-three patients have relapsed in the first six months and two recurrences in ten years, in the reconstitution of the neo-orifice, through which passes the cord. In the remaining patients the mesh were relocated upward and medially (as identified by the clips of the increase of 10-15%).
CONCLUSION: Our study shows that the mesh migrates upwards and medially. Migration is more or less, depending on the patient’s age and quality of its tissue. Fix the prosthesis is good practice to secure at the flag on the inguinal ligament leads to two advantages: not to frustrate the principle tension-free, since the fixed prosthesis on one side does not create moments of tension, and prevent the prosthesis returns to the opening road to relapse.

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